Laparoscopic Closure of the Nephrosplenic Space in Horses with Nephrosplenic Colonic Entrapment: Factors Associated with Survival and Colic Recurrence.
Authors: Nelson Brad B, Ruple-Czerniak Audrey A, Hendrickson Dean A, Hackett Eileen S
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Nephrosplenic Entrapment Surgery and Long-term Outcomes Over a 12-year period, 211 horses presented with nephrosplenic colonic entrapment (NSE), with 91% surviving to hospital discharge—a reassuring outcome for equine practitioners managing this acute colic condition. Researchers analysed factors predicting short-term survival using multivariable logistic regression and tracked long-term mortality and colic recurrence, finding that whilst improving packed cell volume during treatment correlated with better survival odds, concurrent abdominal lesions (such as additional areas of impaction or ischaemia) substantially increased nonsurvival risk. Perhaps most significantly for clinical decision-making, horses that underwent laparoscopic closure of the nephrosplenic space experienced substantially fewer colic episodes post-discharge compared to those managed medically alone (P<0.001), with NSE recurrence occurring in 23% of all cases. Among the 97% of horses surviving beyond one year post-discharge, increasing age at admission emerged as a modest but significant risk factor for delayed mortality. These findings support laparoscopic surgical closure as a valuable intervention for reducing recurrent colic in horses with NSE, whilst highlighting the importance of careful pre-operative assessment for concurrent lesions and close monitoring of older patients post-operatively.
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Practical Takeaways
- •Nephrosplenic entrapment has a good prognosis with 91% short-term survival; horses that survive to discharge have excellent long-term outcomes (97% alive at 1+ year)
- •Horses presenting with concurrent abdominal lesions alongside NSE warrant more guarded prognosis and closer monitoring for complications
- •Laparoscopic closure of the nephrosplenic space significantly reduces colic recurrence rates and should be considered to prevent repeat episodes
Key Findings
- •91% of 211 horses with nephrosplenic entrapment survived to hospital discharge; 97% of survivors remained alive ≥1 year post-discharge
- •Positive change in packed cell volume (PCV) from admission to post-treatment was associated with reduced odds of nonsurvival (OR 0.899, P=0.03)
- •Concurrent alimentary lesions significantly increased odds of nonsurvival (OR 8.47, P=0.02)
- •Laparoscopic closure of nephrosplenic space reduced recurrent colic episodes compared to horses without closure (P<0.001); recurrence occurred in 23% of all horses